Kansas Boy Declared "Brain Dead:" Be Cautious Before Reaching Conclusions
The tragic case of a teenage boy catastrophically injured in a shooting accident is all over the WEB. Apparently the boy was wounded in the neck and later declared dead by "neurological criteria," with the University of Kansas Hospital insisting on removing life support and taking the "body" out of the ICU. The family believes their son is still alive and has obtained a restraining order to continue treatment.
The common term for death by neurological criteria is "brain dead," an unfortunate phrase because it implies that every cell in the brain must be dead when it actually means that the entire brain and every constituent part has permanently and irreversibly ceased to function as a brain.
Let us not get into whether such people are really and truly dead for now. If the hospital in this case accurately determined death by neurological criteria, the life support should be removed after giving the family a decent time to say goodbye. However, if the diagnosis was improperly made, we have a completely different issue.
I have some behind the scenes information on this that I won't publicize. Part of the problem may be the way the family was treated by one particular person on the medical team. If anything, situations like this require sensitivity, compassion, and empathy. Curt conduct, denigration of faith, etc., lead to the very kind of controversy you see here because it destroys trust.
I will be following this case closely. My betting is that the judge will order an independent examination that follows all of the necessary protocols for declaring death by neurological criteria. I hope so. It will bring clarity and if the poor boy is dead, the family has a right to know from what they consider a trustworthy source. Once that necessary first step in resolving this terribly tragic episode is completed, then we can make informed decisions about where things should go from there.
posted by Wesley J. Smith @ 8:06 AM
3 Comments
3 Comments:
I worked with a patient who had shot himself in his head...he too was DX as being BRAIN DEAD. He was in a coma for over a year. Then he woke up. After months of PT, OT, Speech and other therapies he was able to discharge himself home; he walked out of the facility and drove himself off.
We can't count these people as being dead as fast we some would like.
This is why there need to be uniform standards, which include a detailed history. Otherwise, patients can begin to be perceived by some as mere organ systems. Thanks for writing.
Last month (July, 2006), my mother was diagnosed as PVS (persistent vegetative state). The doctors said that we should "pull the plug". Well, I could see that my mother was trying to communicate. The doctors kept saying "that's just reflexes" and "that's not purposeful movement". I knew it was purposeful movement. I had to convince my family that my mother was trying to communicate with us. My family agreed to let me make the decision to not pull the plug. My mother started responding to the family a couple of days later. She, also, begin to make responses to the medical staff. I was angry that the doctor made this diagnosis at only 10 days. How dare he do this!? The mental anguish that he caused our family. The hospital staff was even acting like she was dead, and they spoke rudely to us, and acted as if we were ignorant children. I'm a nurse. I know the difference between being diagnosed as PVS and the difference between being diagnosed brain dead. I was suprised that the nurses in the ICU didn't know the difference and that some of the doctors didn't know the difference either. Furthermore, they didn't even know the time frame for diagnosing someone as PVS, the difference between persistent, permanent vegetative state, and brain dead. It was like I was in the twilight zone. My mother does have anoxic brain injury, but there are times that she can speak (with a passie-muir valve in place). Then there are times that she seems nonresponsive or less alert.
And as far as the Ambien goes, what harm is there in trying it! It doesn't take a rocket scientist to say hey let's see if this works or not. What's the big deal? Why aren't the neurologist looking into this?
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